Just because she said she's a nurse doesn't mean that she was, I haven't seen any info to prove that yet.

I know medical assistants, med students and nursing students that say they're nurses when calling places just because it's easier to say. And depending on where they are in their education, they might have not completed the BLS course yet.

There's also the matter of whoever was in the background calling the shots.

Well I don't believe it's okay to lie to an emergency dispatcher because it makes your life easier and you don't feel like explaining the situation properly lol she argued (sounding really unconcerned and bitchy with the dispatcher for 7 minutes) at some point she should have admitted I'm not a nurse, I'm not allowed, no ones gonna help- send help, kthnxbai and hungup if she wasn't gonna do anything.

If 911 asks me to read Chinese I'm gonna do the best I can because that why I called 911. They do this everyday, they know what theyre talking about. Who am i to question? I don't care if anyone tells me I'm not allowed. Go ahead and sue me, I'd rather be able to sleep at night

Well I don't believe it's okay to lie to an emergency dispatcher because it makes your life easier and you don't feel like explaining the situation properly lol she argued (sounding really unconcerned and bitchy with the dispatcher for 7 minutes) at some point she should have admitted I'm not a nurse, I'm not allowed, no ones gonna help- send help, kthnxbai and hungup if she wasn't gonna do anything.

If 911 asks me to read Chinese I'm gonna do the best I can because that why I called 911. They do this everyday, they know what theyre talking about. Who am i to question? I don't care if anyone tells me I'm not allowed. Go ahead and sue me, I'd rather be able to sleep at night

Well good for you, I'm glad you know exactly what you're going to do in an emergency.

I'm pretty sure it's illegal to claim to be a nurse if you aren't so at the very least they can nail her for that hopefully.

Why does she have to be nailed for something? Just because she's the one you hear on the recording doesn't mean she was the only person calling the shots.

Have you been to one of those facilities? The residents usually have their own apartments and the dining area is one of the common areas that everyone shares. Very often there are just a few employees, depending on what time of day it is because the residents are expected to be able to take care of themselves in some capacity and those that aren't are in a different wing.

Also, the dining areas are usually towards the middle of the facility so the woman who made the call would probably have had to leave the collapsed lady on the floor either on her own or with people who couldn't help her in any way on the off chance that someone would be passing by the facility. If she was there with other residents, who's to say that they could have performed CPR? What if they were in wheelchairs, how would they be able to help?

The woman followed the company's policy and she called 9-1-1, she was willing to help to some extent. If she had hung up on the operater like you suggest, she'd have been under even more fire than she is right now.

So - as per your last quote - calling 911 wasn't indicative of their belief that the woman could be saved if someone got there in the nick of time. All they were doing was calling 911 to say that they had a patient that was non-responsive as per what they were mandated to do. We don't really know the facts. The exact same thing happened to a family member of mine who was a DNR. They called 911 and administered oxygen until paramedics arrived but the passing was pretty quick. If there wasn't a DNR in place in this particular case, then they were (according to the facility) made aware of the rules about manual CPR. If this wasn't explained to the family and patient at the time of her placement in the facility, then a legal case can be made.

I am sure the courts will have to sort this out. No doubt attorneys have been contacted.

It does look like the nurse would've felt it was her moral obligation and duty as a medical professional to try cpr to save the woman's life. If it is corporate policy to not attempt the cpr and the medical examiner determines that the lady could've been saved, well the I'd hate to own stock in that company because their ass will be chewed up and spit out in a lawsuit.

I am sure the courts will have to sort this out. No doubt attorneys have been contacted.

It does look like the nurse would've felt it was her moral obligation and duty as a medical professional to try cpr to save the woman's life. If it is corporate policy to not attempt the cpr and the medical examiner determines that the lady could've been saved, well the I'd hate to own stock in that company because their ass will be chewed up and spit out in a lawsuit.

That right there is one of the reasons policies like that are in place. People are so quick to file lawsuits these days, facilities/companies put as many policies in place to cover themselves as they can.

if the Nurse give the CPR now and old lady die what happen???the old lady family will take the nurses to court i am sure then she will be charge...in the law say she not allow to give the CPR but she still give it

yesprotocol is protocol who can say what the nurse did the right thing

Joined: 4/15/2011Posts: 7,543Location: Soaking up the sun, United States

Dancing_Doll wrote:

Actually they are mandated to call 911, even in cases where there is a DNR. The care delivered by medics may strictly be palliative (eg. oxygen, morphine etc.) in those cases however, until the person passes.

NOT true. (I deal with hospice patients daily)

I agree with one winged angel, I know so many people who call themselves a "nurse" CNA's, lab techs, even Vet techs. None of them are nurses but I hear it everyday. (by the way, to someone who has worked very hard to get her BSN, I find these kind of labels on unlicensed personal to be very insulting.)

Additionally in the state of FL, you might have signed a DNR, but if it isn't signed by the Dr & printed on the correct shade of yellow, it isn't legal, and would count as "no DNR signed." Not enough facts given to judge this case.

So - as per your last quote - calling 911 wasn't indicative of their belief that the woman could be saved if someone got there in the nick of time. All they were doing was calling 911 to say that they had a patient that was non-responsive as per what they were mandated to do. We don't really know the facts. The exact same thing happened to a family member of mine who was a DNR. They called 911 and administered oxygen until paramedics arrived but the passing was pretty quick. If there wasn't a DNR in place in this particular case, then they were (according to the facility) made aware of the rules about manual CPR. If this wasn't explained to the family and patient at the time of her placement in the facility, then a legal case can be made.

Huh? someone said up above that CPR can do more harmthen good. if it was gonna leave the patient worse off she could have not called 911 and saved the patient pain and suffering and let her pass, if she called 911 knowing she couldn't perform it she thought it would have been best for her for someone to get there who could help herno point in calling 911 if I know it's only gonna do more harm than good.

I never mentioned the policy or if there was a dnr, it's already been confirmed there was no dnr or pretty much all these articles and news broadcasts are wrong.

(edit) nevermind I see what you meant, I was just saying hypothetically. What I said is just a random part of my opinion

Really? So if a person is struggling or suffering, there is no requirement to call 911 or offer palliative care? To my understanding - all a DNR is that it alerts paramedics not to perform aggressive chest compressions, intubation or mechanical ventilation in case of an emergency. Other than that, I think everyone would agree that some degree of palliative assistance if the patient is still alive is mandatory. In those cases it's about relieving suffering rather than reviving. At least that's what happened with my family member at the assisted-living centre they were at. Maybe I'm not understanding what you're saying. Do places exist where the policy is just to shut the door and wait a few hours and check on them again until they're dead without any medical assistance? That doesn't seem right. :(

If there was a DNR I doubt that this would've made the news. I am sure everyone involved are nervously waiting on the report from the coroner's office. That will most likely determine the direction that this goes.

If there was a DNR I doubt that this would've made the news. I am sure everyone involved are nervously waiting on the report from the coroner's office. That will most likely determine the direction that this goes.

I don't think it will go to a lawsuit, The family said it was aware of the policy

I'd like to see criminal charges filed on all the staff that were present but they're protected because they aren't allowed to perform CPR. Some of what I read and watched says the director hasn't commented on why she claimed she was a nurse or a nurse was present if the facility didn't employ nurses, so either she was a nurse not on staff that let her die, or she was a staff member impersonating a nurse claiming she was one. she could be arrested for that I'd hope. If she was an unstaffed nurse she should be responsible. not the staff, nothing was stopping her as she wouldn't have had to follow that rule since she didnt work there. If she lied she should be charged for that provided what she claimed is illegal.Doctor practicing medicine without a license is illegal, does claiming to be a nurse to a 911 dispatcher when your not fall into something similar.

If there was a DNR I doubt that this would've made the news. I am sure everyone involved are nervously waiting on the report from the coroner's office. That will most likely determine the direction that this goes.

Yeah, but by virtue of the fact that the facility tells patient and family that they will not perform CPR in case of emergency - it's almost like an interim DNR on some level. I have to assume they can't be sued if the policy was explained and forms were signed showing understanding of procedure.

Joined: 4/15/2011Posts: 7,543Location: Soaking up the sun, United States

Dancing_Doll wrote:

Really? So if a person is struggling or suffering, there is no requirement to call 911 or offer palliative care? To my understanding - all a DNR is that it alerts paramedics not to perform aggressive chest compressions, intubation or mechanical ventilation in case of an emergency. Other than that, I think everyone would agree that some degree of palliative assistance if the patient is still alive is mandatory. In those cases it's about relieving suffering rather than reviving. At least that's what happened with my family member at the assisted-living centre they were at. Maybe I'm not understanding what you're saying. Do places exist where the policy is just to shut the door and wait a few hours and check on them again until they're dead without any medical assistance? That doesn't seem right. :(

I didn't say that you shut the door and walk away. Here's an example:

I had a pt last week with a fib. She experienced periods of non responsiveness from time to time related to her disease process. We checked on her hourly, making certain she was comfortable, her o2 sats were good, she was turned, heels floated, changed her to an air mattress, preformed oral care, ect. She had a signed DNR in place, and her family was aware of the situation. When she passed it was quiet & peaceful. Death was pronounced by the RN, family was notified, MD was notified, & the funeral home was called.

I had a pt once who transferred to our facility. Her paperwork didn't all come appropriately at the time of transfer(happens more then you would think). I had a verbal report that she had a signed DNR in place but no physical yellow sheet. She coded within 8 hrs of her arrival. We were required to start CPR and call 911. In that case she ended up having her leg DRILLED into to start a line. Her chest compressions lasted for 30 minutes as we tried to reach business offices at 7a to get a copy of her DNR. I know from later speaking to the family that they were just as upset that we did the CPR then some others would be if we hadn't.

The above is a review of the crisis within the NHS in England. Institutional Neglect some have described it as, some have advocated that willful blindness was in play, some commentators have blamed fear, standards, concerns over league tables and so on as the causal factors.

The reality is that people become weary and tired of raising concerns, if there concern isn't addressed it is unsurprising that people conform tot he will of those in power. Whistle blowers have been vilified, staff have lost their jobs, a climate of fear prevails.

In reading this particular (not black and white) case I was struck by the fact that once again humanity has been placed under the microscope and we don't like what we see, we have no choice therefore but to come down on one side or the other and find someone to blame, sadly we exist (certainly in the West) where we need, yes need, someone to blame, that way we don;t have to see our role in the mess we have made of the world, and yes we are all responsible in some way for this event here and the events of Mid Stafford-shire, we have allowed this to happen, generally as a result of our apathy. When the spotlight shines we throw our arms up in disgust and say how could this happen.

Imagine your the nurse in this scenario, working I don't know how many hours to provide for her family, maybe at each case review the nurse has raised this issue, and each time her thoughts and views were overlooked. Is it surprising that she toes the party line? hardly a surprise I'd say.

Who can truly say with total conviction that they would risk losing their livelihood (especially in the current economic climate) and be resolute enough to say, I won't feed my children, provide a home for them, clothe and keep them warm, if the institution they work in has policies and procedures that tie staff up in knots and leave them with feelings of being unable to affect any change, I know I would LOVE to say that I would, but I am really not sure, not 100% sure anyhow.

Without wishing to sound too trite, we cannot and should not judge someone until we have walked a mile in their shoes, in the fullness of time this nurse will undoubtedly have to find a way to cope with the outcome, the facility owner's will also have to find a way to cope. Rest assured no matter how we may appear, when we are alone and left with our thoughts we will certainly reflect upon our actions, and having to deal with the ramifications will take its toll, of that I am sure. (thinking is one of the most stressful things we do!)

Life is never ever black and white, people make decisions and have to live with them.

Time and the inevitable investigation (and the even more inevitable outcome, lessons have to be learned, which invariably are not learned) will no doubt decide who is or is not responsible.

Hopefully some enlightened people with common sense will come up with a more empathetic process, until then we could (as human beings) give the nurse involved the benefit of doubt.

Joined: 4/15/2011Posts: 7,543Location: Soaking up the sun, United States

Dancing_Doll wrote:

Yeah, but by virtue of the fact that the facility tells patient and family that they will not perform CPR in case of emergency - it's almost like an interim DNR on some level. I have to assume they can't be sued if the policy was explained and forms were signed showing understanding of procedure.

Our CNA's are NOT allowed to perform CPR. And they frequently call themselves nurses.

I had a pt last week with a fib. She experienced periods of non responsiveness from time to time related to her disease process. We checked on her hourly, making certain she was comfortable, her o2 sats were good, she was turned, heels floated, changed her to an air mattress, preformed oral care, ect. She had a signed DNR in place, and her family was aware of the situation. When she passed it was quiet & peaceful. Death was pronounced by the RN, family was notified, MD was notified, & the funeral home was called.

I had a pt once who transferred to our facility. Her paperwork didn't all come appropriately at the time of transfer(happens more then you would think). I had a verbal report that she had a signed DNR in place but no physical yellow sheet. She coded within 8 hrs of her arrival. We were required to start CPR and call 911. In that case she ended up having her leg DRILLED into to start a line. Her chest compressions lasted for 30 minutes as we tried to reach business offices at 7a to get a copy of her DNR. I know from later speaking to the family that they were just as upset that we did the CPR then some others would be if we hadn't.

There are many courses on nursing ethics. It can be quite complex.

The second case you described sounds awful.

I assume each type of facility has their own procedure in place, maybe also related to how much care they are actually able to provide in that setting and what kind of medical personnel is there at the time. An assisted living centre like the one this woman was in really has limited means to treat. It's more 'carers' than registered nurses (compared to a hospice environment).

Joined: 4/15/2011Posts: 7,543Location: Soaking up the sun, United States

Dancing_Doll wrote:

The second case you described sounds awful.

I assume each type of facility has their own procedure in place, maybe also related to how much care they are actually able to provide in that setting and what kind of medical personnel is there at the time. An assisted living centre like the one this woman was in really has limited means to treat. It's more 'carers' than registered nurses (compared to a hospice environment).

It was to be honest. What do you do? You know the pt wishes, but legally you have to do something else. I can't afford to lose my liscense!

That is exactly why I say we font have enough information to judge this case!

Joined: 10/21/2010Posts: 3,401Location: The wilder parts. , United States

Dancing_Doll wrote:

Really? So if a person is struggling or suffering, there is no requirement to call 911 or offer palliative care? To my understanding - all a DNR is that it alerts paramedics not to perform aggressive chest compressions, intubation or mechanical ventilation in case of an emergency. Other than that, I think everyone would agree that some degree of palliative assistance if the patient is still alive is mandatory. In those cases it's about relieving suffering rather than reviving. At least that's what happened with my family member at the assisted-living centre they were at. Maybe I'm not understanding what you're saying. Do places exist where the policy is just to shut the door and wait a few hours and check on them again until they're dead without any medical assistance? That doesn't seem right. :(

The purpose of hospice care is to help people die. When a person goes into hospice care they go with the understanding that they are not going to recover from whatever disease is killing them. The idea is to keep people as comfortable as possible while they die. Access to pain killers is usually better under hospice care, and is one of the reasons some people enter a hospice in the final stages of their illness instead of going to a hospital for more treatments.

I don't know enough about his particular case to comment on it, but there are many people who don't want to be kept alive after the point where their lives are no longer worth living. Whether or not the patient in this case wanted to be kept alive is the only valid question.

The purpose of hospice care is to help people die. When a person goes into hospice care they go with the understanding that they are not going to recover from whatever disease is killing them. The idea is to keep people as comfortable as possible while they die. Access to pain killers is usually better under hospice care, and is one of the reasons some people enter a hospice in the final stages of their illness instead of going to a hospital for more treatments.

That makes sense in a hospice situation - but this patient wasn't in a hospice environment. My original comment was pertaining to someone who was in an independent or assisted living centre (like this patient) and the requirements of calling 911 if the patient became non-responsive. I assumed it was mandatory to do so (regardless of whether a DNR is in place or not, or whether the facility can provide interim CPR). When naughtynurse said 'no', it surprised me. I can understand not doing so in hospice, but independent/assisted living seems like a whole other scenario. Maybe we're all talking about different things on this one. That was more of a side issue anyway. If the patient and family were aware of the limitations of this particular facility and were fine with the arrangements, I don't really see any breach of conduct in a legal sense.

Joined: 10/21/2010Posts: 3,401Location: The wilder parts. , United States

Dancing_Doll wrote:

Maybe we're all talking about different things on this one. That was more of a side issue anyway. If the patient and family were aware of the limitations of this particular facility and were fine with the arrangements, I don't really see any breach of conduct in a legal sense.

It appears that the patient did not have a DNR on file. According to the facility spokesperson, Jeffery Toomer, "In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives. That is the protocol we followed."

That's a policy that needs to change. I expect that it will after the lawsuit.

Joined: 4/15/2011Posts: 7,543Location: Soaking up the sun, United States

Dancing_Doll wrote:

That makes sense in a hospice situation - but this patient wasn't in a hospice environment. My original comment was pertaining to someone who was in an independent or assisted living centre (like this patient) and the requirements of calling 911 if the patient became non-responsive. I assumed it was mandatory to do so (regardless of whether a DNR is in place or not, or whether the facility can provide interim CPR). When naughtynurse said 'no', it surprised me. I can understand not doing so in hospice, but independent/assisted living seems like a whole other scenario. Maybe we're all talking about different things on this one. That was more of a side issue anyway. If the patient and family were aware of the limitations of this particular facility and were fine with the arrangements, I don't really see any breach of conduct in a legal sense.

Hospice is not a facility, although some hospices have facilities. It is a way of managing end of life transitions and can be implemented anywhere including home environments.

CPR is a huge liability if implemented improperly, which is very easy. Once it has been initiated it cannot be stopped for any reason until the person has been revived or pronounced. It does not suprise me that an ALF would have this type of policy.

I don't know details. I just think that blanket judgements when we don't know the all facts is a bit harsh.

The above is a review of the crisis within the NHS in England. Institutional Neglect some have described it as, some have advocated that willful blindness was in play, some commentators have blamed fear, standards, concerns over league tables and so on as the causal factors.

The reality is that people become weary and tired of raising concerns, if there concern isn't addressed it is unsurprising that people conform tot he will of those in power. Whistle blowers have been vilified, staff have lost their jobs, a climate of fear prevails.

The current cases of willful negligence in the NHS have nothing whatsoever to do with this case or similar decisions not to resuscitate. Those were down to mistakes made at the highest level of the NHS and DoH and the consequences of those mistakes filtering down to the rank and file. In my opinion the "nurse" in this, given the facts available, DID NOTHING WRONG. Making parallels between these cases is missing the point entirely.

Was the emergency dispatcher medically qualified? Almost certainly not. Like most people here, they probably thought that asking someone to perform CPR would be the best course of action. It wasn't. If anything, they should be reviewing their dispatcher about offering emergency medical advice over the phone.Warning: The opinions above are those of an anonymous individual on the internet. They are opinions, unless they're facts. They may be ill-informed, out of touch with reality or just plain stupid. They may contain traces of irony. If reading these opinions causes you to be become outraged or you start displaying the symptoms of outrage, stop reading them immediately. If symptoms persist, consult a psychiatrist.

Joined: 1/31/2013Posts: 3,104Location: Curled up in front of a beautiful fire

We always hear about this kind of thing coming out of America..People seem to dial their lawyers rather then 911 half the time.Only you as a people can change this mentality..it would be a society change that the insurance companies would fight to the end. and Man kinds greed would be the other item you would be fighting.I live in a country that we don't pay a lawyer to make us money if we slip over at someone's house..but i am sure being a western society country we will follow suit...I just wish and hope it isn't in my life time.

There are many points that have been made about this woman and the dispatcher... Forget about lawyers, lawsuits and all the legal garbage... It comes down to one thing... What society in America is becoming... People who would rather follow policy than do the right thing... I have performed CPR at work numerous times, probably 80% of the time it didnt save a life, even with an AED... To me its about wanting to help, wanting to do something, just trying... I for one could not work in a facility that wouldnt allow me to perform CPR... I think the dispatcher can sleep at night knowing she tried to do something... As for the nurse, that is something she has to decide... I dont think she necessarily deserves to go to jail, maybe just some true, deep, soul searching on her part... But then most of society needs to do that... We are slowly becoming a greedy, me me me society... Truly a shame...characterized by intense feeling; passionate; fervent

An 87 year old woman died after collapsing in her Assisted Living Facility. Not a nursing home, these residents are still partly able to care for themselves. It's like an apartment complex for the elderly, they do receive aid but are still mostly self sufficient.

After the woman collapsed, a call to 911 was made. A nurse got on the phone and refused to give CPR even as the emergency operator implored her too. Absolving her and the facility of any responsibility if the lady died anyway. Btw, the elderly lady did NOT have a DNR on file. For over seven minutes, the nurse stayed with the dying woman but would not do anything to help.

The 911 operator pleaded for help from someone who didn't work at the facility...

"I understand if your boss is telling you, you can't do it," the dispatcher said. "But ... as a human being ... you know, is there anybody that's willing to help this lady and not let her die?"

"Not at this time," the nurse answered.

"Is there a gardener? Any staff, anyone who doesn't work for you? Anywhere? Can we flag someone down in the street and get them to help this lady? Can we flag a stranger down? I bet a stranger would help her."

"I understand if your facility is not willing to do that. Give the phone to a passer-by. This woman is not breathing enough. She is going to die if we don't get this started, do you understand?"

So far, there has been no response from the woman's family.

Should the nurse be charged with a crime? The facility?

Actually, The 911 operator should be the one that is terminated. A phone operator is going to question a health care professional about thier patient care? really? I think this is a case where the nurse why just lying to the operator, to safeguard against breaching patient confidentiality, A major " DON'T" in the health care industry. Even disclosing that her patient was DNR to a 911 operator would be a breach. Not only would the nurse lose thier job, but also thier nursing license. Patient information is given out on a need to know basis and only given to personel DIRECTLY related to providing her with health care, or say a diagnostic service. The operators job is to get EMS dispatched asap and that's all. There is nothing the operator can do that is going to directly change that patients status. Patients have a right to privacy. therefore, all information regarding patients and thier care is classified as confidential, and only given on a need to know basis.

Actually, The 911 operator should be the one that is terminated. A phone operator is going to question a health care professional about thier patient care? really? I think this is a case where the nurse why just lying to the operator, to safeguard against breaching patient confidentiality, A major " DON'T" in the health care industry. Even disclosing that her patient was DNR to a 911 operator would be a breach. Not only would the nurse lose thier job, but also thier nursing license. Patient information is given out on a need to know basis and only given to personel DIRECTLY related to providing her with health care, or say a diagnostic service. The operators job is to get EMS dispatched asap and that's all. There is nothing the operator can do that is going to directly change that patients status. Patients have a right to privacy. therefore, all information regarding patients and thier care is classified as confidential, and only given on a need to know basis.

I disagree. Anybody's right to privacy is never as strong as the right to live. If you disagree to this statement, go out, get mugged, stabbed and shot, then see whether you want the 911 operator to limit his activities to dispatching EMS onsite or whether you expect him to ask questions in order to determine your state of urgency and thus your priority on the plethora of 911 calls in any medium-large city.

My wife is a doctor, a GP (General Practitioner, aka Family Doctor). She cannot refuse to visit a neighbor, if critical, even if said neighbor is not officially one of her patients. It's a crime and she would be arrested for that.

I am aghast that an old people's home (or whatever) has a blanket DNR policy, it should not have been allowed to operate by the local authorities because it is a breach on the individual's right to live.De facto, it should be grounds for charges of manslaughter.

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